Exploring the barriers, facilitators and needs to use patient outcomes in district nursing care: A multi-method qualitative study

Authors Jessica Veldhuizen, Frans van Wijngaarden, Misja Mikkers, Marieke Schuurmans, Nienke Bleijenberg
Published in Journal of Clinical Nursing
Publication date 2024
Research groups Proactive care for older people living at home
Type Article

Summary

Aim and objectives: To provide an in-depth insight into the barriers, facilitators and needs of district nurses and nurse assistants on using patient outcomes in district nursing care. Background: As healthcare demands grow, particularly in district nursing, there is a significant need to understand how to systematically measure and improve patient outcomes in this setting. Further investigation is needed to identify the barriers and facilitators for effective implementation. Design: A multi-method qualitative study. Methods: Open-ended questions of a survey study (N = 132) were supplemented with in-depth online focus group interviews involving district nurses and nurse assistants (N = 26) in the Netherlands. Data were analysed using thematic analysis. Results: Different barriers, facilitators and needs were identified and compiled into 16 preconditions for using outcomes in district nursing care. These preconditions were summarised into six overarching themes: follow the steps of a learning healthcare system; provide patient-centred care; promote the professional's autonomy, attitude, knowledge and skills; enhance shared responsibility and collaborations within and outside organisational boundaries; prioritise and invest in the use of outcomes; and boost the unity and appreciation for district nursing care. Conclusions: The preconditions identified in this study are crucial for nurses, care providers, policymakers and payers in implementing the use of patient outcomes in district nursing practice. Further exploration of appropriate strategies is necessary for a successful implementation. Relevance to clinical practice: This study represents a significant step towards implementing the use of patient outcomes in district nursing care. While most research has focused on hospitals and general practitioner settings, this study focuses on the needs for district nursing care. By identifying 16 key preconditions across themes such as patient-centred care, professional autonomy and unity, the findings offer valuable guidance for integrating a learning healthcare system that prioritises the measurement and continuous improvement of patient outcomes in district nursing.

On this publication contributed

  • Jessica Veldhuizen
    • Researcher
    • Research group: Proactive care for older people living at home
  • Nienke Bleijenberg
    • Professor
    • Research group: Proactive care for older people living at home

Language English
Published in Journal of Clinical Nursing
Key words community health nursing, home care services, learning health systems, patient-reported outcome measures, qualitative research, value-based health care
Digital Object Identifier 10.1111/jocn.17407

Jessica Veldhuizen

Jessica Veldhuizen

  • Researcher
  • Research group: Proactive care for older people living at home